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Avatar universal

help with megacolon

Hello!  I've an 11-year old long-haired feline who has megacolon.  We move around quite a bit, and I have had to shuffle him between vets, and am about to shuffle him again.   Four years ago, just a few months before we were about to move overseas, he developed a constipation problem.  His American vet gave him an enema and put him on stool softeners to be used only occasionally.  Once we moved overseas, he had several enemas before his vet put him on liquid paraffin every day.  I used to take him for a check every two weeks too make sure that the paraffin was working, and for the most part, it did, like a charm; only very occasionally, the vet would determine that he also needed a micro-lax (which I gather is like a glycerin suppository), and that would sort out any problems--this regime worked for several years.  Still, periodically my vet would mention the prospect of a colonectomy--apparently, from x-rays, he did not absolutely have megacolon at the time, but it was arguable that the colon was at least a bit stretched. This vet had performed many colon-ectomies and assured me that there were few side effects and that it would instantly solve the problem.  I debated this possibility for a long time, and then eventually I needed to move back to the states. Unfortunately, when I moved back, I had to leave my cat for six weeks with my mother.  She says she gave him his paraffin every day (I am sure she did), but when I got home there was an obvious and critical problem.  I immediately called a family vet (literally, a family member who is actually a very well-respected vet).  This vet argued that a colon-ectomy could have serious side-effects, and that I should try to regulate the problem by other means if I could.  This made sense, since I rarely got a negative report during my cat's fortnightly checks overseas; I probably could get the problem under control.  Anyway, I brought my cat in to this vet's hospital, where an x-ray was performed. This time, the diagnosis was definately megacolon. They gave my cat an enema, and tried him on lactulose, since paraffin is not commonly prescribed in this country. This was about six months ago.  Since that time, I have had to switch back to paraffin (I order it from overseas), because the lactulose did not seem to work at all.  I have to say that he seems worse.  He struggles obviously and often in the litterbox, and at first, I thought it was just a stumbling block, getting used to a new place and regime.  My current vet told me that I could give my cat liquid glycerin suppositories to sort out any immediate problems, which I have to do about once a week or ten days.  I take him in for a check every few weeks or so, but lately (I suspect because the weather has been hot) I have been noticing that he dehydrates rapidly, and the problem arises more frequently--he barely ever goes to the litterbox without a liquid glycerin suppository.  I know his urinating is normal, because I am frequently monitoring his trips to the litterbox.  The last two times I have taken him in for checks, they have given him sub-cutaneous fluids and an enema.  They also suggested that I give him pedia-lyte, which I have been doing, though I confess only occasionally, when his flesh 'feels' a bit dehydrated.  My vet seems to think that it is probably the hot weather, but I wonder.  Tonight, for example, he strained four or five times in the box, so I gave him a liquid glycerin suppository.  He feels a bit dehydrated again. He produced a bit of stool, but then resorted to squatting several times outside the box, in several different places, leaking out drops of liquid feces, and he was also vomiting foam.  He did this last time (about a week ago) as well.  OK, so it has usually been an effect of the liquid glycerin suppository that he vomits afterward--it is not always foam, and the vet said that this was normal.  Tonight, his feces has had a strong odor that he does not normally have--normally (at least for the past six months) his feces has had almost no odor.  I would dearly love to order a full blood work-up, but at the moment I don't feel like I can ask for something that my vet does not suggest.  In a few weeks, however, I will be moving a few hours away for a new job that will last a year.  I will continue to see my current vet periodically (I am likely to be a nomad for at least a few more years, and this vet is fairly close to my parents' home), but I will also find one who is close to where we will be living at my new job.  In a sense, I will be glad to have some fresh tests/diagnosis, but it is also difficult to keep moving between vets. Before I make the switch to another vet, I'd love to have an outside opinion of the matter. I know I will be directed a certain way--but is there something I should suggest--any tests, for example? I worry so much about this problem--I keep thinking that something dreadful is going to happen in-between visits to the vet, perhaps even overnight or something, if I am not astute in my observations.  I also wonder if there is something else wrong with him, maybe contributing to the constipation or else happening as a result of it--I really think that I notice changes in his symptoms, but it is hard to present that case--for example, who cares if his feces has a stronger odor all of a sudden?  Maybe it was something he ate!  I realize that I cannot insist upon having him seen and checked every few days, but the 'system' we have going at the moment just does not seem to be working like when we were overseas--everything just seemed so much more consistent then, and I wonder if that last bout of extreme constipation (when he was with my mother) actually changed the problem or created a new one.  There is just something not quite right. Oh, and I should mention that every vet my cat has seen has tried to teach me to 'feel' for constipation--I am hopeless at this.  Further, I should say that the summer here is much hotter than any my cat has experienced over the past four years, when we were overseas. Thanks in advance for any opinions you may have to offer.
77 Responses
Avatar universal
I'm so sorry you and your kitty are going through this.  My cat, Jaxon, is experiencing the very same downturn in his megacolon since he was boarded 3 weeks ago.  I'm being told to aggressively combat it medically, but the Cisapride and laxative seem to no longer be working and he's been to the vet every 4 days, including a surgical consultation.  I'm at my wits (and funds) end.  Have you found someone to truly help you?  
Avatar universal
I hope things are going better for you and your kitty.  I was just like you when I was young.  Please don't hate me, but the kitty needs a stable home environment for years without moving around.  I realized that after I had done the same with my 2 cats and finally found a loving, stable home for them to rest out their days.  I now do cat rescue work and only adopt out to people that are not moving around excessively as it really stresses out the animal and causes severe health issues.  The trips to the vet alone are way too stressful.  Cats are calm, peaceful animals by nature and when you disturb that balance, it is going to show up somewhere.  I only hope that you and kitty have settled down and his health has resolved.  Your cat has been a very patient and loving creature to teach you this life lesson to carry with you after he/she is gone.  Bless both of you, you are in our prayers.
Avatar universal
While I agree that cats prefer a stable home, I don't think it's fair to blame Clary's moving around for the cat's troubles. My 10-year-old cat has the same medical condition and has always lived in the same quiet, peaceful, loving home. Having been through much of the same ordeal as Clary, I know how hard it is to be constantly taking a cat to the vet and giving it daily medications. Clary deserves respect, not blame. My cat is at the vet's today being cleaned out again, and we are contemplating the surgery, but I will only consider the surgery if it will truly help him.
Avatar universal
I read that canned pumpkin is good for constipation in cats and tried it. It took a few tries before my cat actually ate it, but he did and realized it was good.
When my cat started eating canned pumpkin, not pumpkin pie filling his stools completely changed. They became wet and soft and easy to pass.  I added it to his wet food and added extra water. Now he eats canned pumpkin & water as a snack and loves it.  It did stop working for him after about a year though and now he is battling megacolon again.

My 5-6 year old boy was diagnosed about two years ago with megacolon. At first all he needed was extra fiber added to his diet, not he is taking 250-300mg of stool softener a day, extra fiber added to his food, Laxatone and all the canned pumpkin he wants. This was working wonderfully up until two months ago.  I tried Cisapride in multiple doses, but that gave him severe cramps and didnt seem to help him poop.  He has been given enemas from the vet that work well, and I've started giving him enemas when I see that he isn't pooping, but how much is too much? He is a happy cat and never growls or claws when getting an enema. It seems like megacolon can be treated, but suddenly everything that has been working stops abruptly.



Avatar universal
I dont think Tribbles was "blaming" everything on Clary's moving around, but only suggestting another possible cause and opinion; and thats what Clary wanted was our different opinions or suggesstions. I agree 100% with Tribbles as my daughter, who lives in Texas, has the same problem with her Siamese of 11 years. Whenever she and her hubby, who is a doctor, take their trips to places for his medical conventions,their cat gets this problem, without question! Stress is an emotional problem for many diseases--human and animal ! Its a point well taken and it doesnt seem like anything else has worked--so why not consider this? Sometimes vets will put the cats on a small dose of Prozac when their owners go away. Maybe you could suggest this to your vet Clary?
Avatar universal
My cat has the same problems, also Siamese,male, 13 yrs old, this is the typical for this I read, older males
  The lactulose helped at first and he was getting along well, with that and changing to all wet food and i got one of those little water fountains for pets that keeps their water flowing and they love it,
  so he drinks more water I also use filtered water from the tap, always have.

The lactulose stopped working and just seemed to make him lay around feeling bad , so after reading on line about the liquid glycerine, I tried getting a suppository in him with no success,
  I then got the baby lax, it is liquid glycerine in a prefilled prelubricated little plastic bulb/bottle with a tip for inserting, it holds 3ml which is ok for a cat according to the Veternarian Merck manual on line although they recommend soap suds, YUCK.

In fact it seems like they reccommended way more than that and I felt it highly wrong the amount they recommended.

A couple of weeks ago he got stopped up again and we had to go to the er on the weekend, they cleaned him out under anesthesia like my vet did the first time he got sick and i didn't know what was wrong,

well they put him on Cisapride and it has done nothing for him.

We had a big episode this weekend having to use the babylax.

So we have decided to use a baby lax once a week before he gets into trouble, because by the time they are crying not able to poop it is really hard to give an enema.

I use a tiny bit of oragel to numb his tush.  

I think this will work , he has vommited foam a little with the baby lax, I get cvs brand, but I think if we do this before he gets so stopped up he prob won't vomit.
  I will try the pumpkin too.
Don't feel bad at the feeling part.  I have medical training and I could tell how large and how much stool was there once I knew what his problem was,
but this last time the er vet said his stool wasn't real big and round cos I told her I feel him every day and I didn't feel much stool but he obviously couldn't poop and getting very ill that is why we took him and she said that his stool wasn't very big but it was very dry.

I don't think soap suds enemas are good .  I remember reading years ago the medical prof didn't recommend them anymore cos they found they could actually do harm to the colon, what I don't remember but i never dreamed that was what my vet used but the er doc said that is what they use , it must be a special soap, but the Merck manual even reccommended it .

Now the enema is a two person job unless your cat is awful good.

I think with our new plan after a while he won't try to get away , I put xtra vaseline on the tip, and the tip looks enormous.

I only put it about half way in but if you feel no resistance it is oK to put a little farther.  You want to gently but firmly put it in and angle down a little towards the tummy as thier colon slants downward.  Hubby holds him at the shoulders and i wrap one arm around and under his back legs and hold up against me or he wriggles real hard.

You squeeze the little bulb and the liquid goes in don't worry you can't even get all of it in.

I always hold him in my arms afterward to keep the liquid in as long as you can even if it is just a minute. And of course lots of baby and love talk and I'm so sorry and many kisses on the head.  Ha , he is not buying it too much for long cos they have to go.

Also I put him in the bathroom where the litterbox  is and close the door, he hates it but if I don't he poops all over the house.   I must say I am happy even when he did this.

I have heard of another surgery where they widen the pelvic outlet so the poop can come outeasier, but I haven't researched it well yet.

A few times when he has hurt his tush by straining and after he had his first treatment at the vet I used a little prep H on it, she gave me ointment and said it would do better but it didn't do a thing for him.
Saline is also recommended by Merck Vet manual, but a BIG important thing is to warm it!  I put the baby lax bottle in a cup and run hot water on it a few minutes.
I hope some of this was helpful, your pumpkin info was good, I had forgot about that and also the pedialyte in the water is an excellent idea!  
Stress is related but I think they get stressed form the first time they have a difficult time and they avoid going to the box and as they continue to do this and keep getting constipated with us none the wiser it backs up and causes the colon to extend and eventually end up with the megacolon.  So I talk soothingly to Simba when he is trying to poop, and PRAY,  I really think the pro active glycerine enema is going to be our answer.
We have decided on Thurday nights.
Avatar universal
Well, I am excited , right after posting I started researching again and the very first article is fantastic and the best I have read so far.

This is by a vet who's credentials are listed at the beginning and to say the least , I AM IMPRESSED!!

I am going to post the link , but I do want to add that he has charts of meds and enemas and all thier pros and cons,

he lists Cisapride but that it does'nt start working for 1-2 wks!!!! NOBODY TOLD me this! Not the er doc,not the pharmacist either!! but he mentions the exspense of it, it has to be compounded and one months supply cost me 40.00, now my cat is worth that to me!!  If it works, but get this, he lists Ranitidine/Zantac and it that it has good safety margin,  well, I have a cofession to make.  I have a colon condition, life long and it causes chronic constipation, yes, it is easy to say on line :)
Lets just say all the fiber,water , laxitives, ect. don't do me much good.

Well, I hadn't had heart burn or indigestion problems in years but a few months ago this started up. well I got The walmart Ranitidine for it, amazingly after about 4 days of using this I started having normal BM, it took me a while to put two and tow together then I read on line in another article that this had helped in lab tests but not tried in cats yet.   NONE of the vets had even heard of it, well, it only takes it 12-24 hrs to start working acording to this drs chart.  Also the reason cisipride wasn't given to start with was it was off the market temporarioy, now I find out why in this article, becauseit was causes cardiovascular problems!  Well the first er doc told me she heard a heart murmur in Simba!  of course that was before he started the cisipride.  but he shouldn't be taking it I think after reading all this, and ranitadine is safe so guess what?   Yes,

please read this article, it is so good and God bless and I pray all our kitties are well soon!

http://www.theveterinarian.com.au/clinicalreview/article757.asp
  
Avatar universal
I checked the link to see if it works and it does but it takes you to the main web site page, wow.

the article is down the page a litte,

The Management of Constipated Cats. by Darren FOster,
Avatar universal
One more link, it has a lot of good info too for cats and costipation.

http://www.littlebigcat.com/index.php?action=library&act=show&item=constipatedcats
Avatar universal
OMG i am sooooooooooo sorry 2 hear that!!!!!!!!! :'( my kitty went 2 the vet this morning cuz he was constipated and he was diagnosed with megacolon and will stay there for a couple days. i'm crying my eyes out at the moment. my cat means the world 2 me. i'm drivin up there 2morrow 2 c him and talk 2 the vet. i will pray for you and your lovely cat. i ask for everyone kindly to please pray for my cat. i can't handle this. i'll do absolutely anything to keep him alive. thank you :) God bless you all!!

*xoxoxoxo*
228686 tn?1211554707
I've been following this thread and been fairly fascinated. I've never had to deal with a megacolon issue to this degree personally, and was impressed by the amount and variety of helpful info in it.

I still shudder at the concept of giving a cat an enema. I think I will call for the 49th Paratroopers to come in to handle it...or perhaps SWAT. I'd think it would require lots of body armor. :)

I don't know if this will help anyone but as dry stool from lack of hydration is a major contributor, I've taken kitty's who seemed to be starting to have this issue and put them in a seperate room with wet/moist food, water...and a humidifier on VERY high (I'm talking, you get dew break in the room in the morning).

I'm not saying how helpful it is, but after a few days of this things seemed to settle down some. Perhaps it was just a coincidence and the diet alone cleared up the issue, but there ya go!
Avatar universal
What I learned since my last comment in November is that a heating pad under a light blanket will go a long way toward providing more comfort, particularly when lactulose is given (as it makes the kitties crampy).  My cat now goes right to the spot where the heating pad is normally placed after his morning meals.  I'm really happy to say that he's doing much better than he was in November.  It was being boarded that threw him for a loop and that will never happen again for him.  But, generally, the fight for comfort goes on.

Also, I bought a drinking fountain for him and give him bottled water and that seems to encourage hydration.  

I am wondering, though, if any of you can help me on the following related issue.  My cat has been low on energy and I finally realized that anyone under constant meds is going to experience vitamin depletion.  I bought a natural vitamin supplement, but WOW does it seem to constipate him.  Can anyone recommend one that does not?




azb0840...I hope you and your kitty are doing better.
Avatar universal
Clary, how is your kitty doing?
228686 tn?1211554707
What's the make up of the vitamin you got your kitty? If it's high in iron, that's probably the problem. Even people get constipation issues with iron.

the heating pad is a great idea. I've used that around here on occasion for sick cats. Of course, we end up with ten cats all trying to pile on the "warm spot". :)
Avatar universal
All I can say is my precious cat "baby" is being given one more chance tonight before they put her down tomorrow.She has had megacolon for quite some time and we have done everything to no avail.It is so heartbreaking to see a sick,harmless cat.
  Last month,the vet removed all the stool from her colon.Naturally she had a general anesthesia.We finally got her back home to the point where she was eating on her own and was very happy but the same thing is happening again and this time,it is bad.
  I wish anyone with this problem with their cats all the luck in the world.It broke my heart.
Anne
228686 tn?1211554707
Anne, I hope it works out for the best. i'm sorry to here your baby is going through these troubles. Hopefully, you'll have a small cat sized miracle between tonight and tomorrow.
Avatar universal
Our cat went through the same probs. We were desperate.
We tried everything.
Then we increasd lactulose to 10 ml a day as opposed to 3-4 ml a day
it was a miracle, he started going.
Please try it
Our love
Avatar universal
Savas, I will check the iron content tonight. Thank you for your suggestion.  

Anne, did your baby make it?  I hope so.

I forgot to note another thing that is helping tremendously. A calendar.  I posted a calendar on the fridge and chart Jax's 3x/day cisapride; the day, time of day and amount of lactulose that is given; and his condition that day (signals, behavior, appetite, etc.).  I figured out his distress signals to me--peeing on rugs (thankfully not the carpet), yeowling loudly in the hallway, butt protrusion--and that every other day of laxing him works best (but sometimes more frequently dependent on his symptoms).  It has helped us deal better and more preventatively with the megacolon.  I'm happy to report that Jax has not needed a manual evacuation or enema since December!  I'm sure he's happier about that. :)  I attribute that to the calendaring.  

Oh, and when Lactulose makes kitties' stomachs too upset to eat, baby food will get them eating again.  Beechnut seems to have the cleanest ingredients.  I also give Jax baby food when he seems particularly constipated and it seems to help.

Good luck to all of us and our babies.

Avatar universal
Oh, and no dry cat food!
Avatar universal
our 12 year old had to have feces removed by surgery. Nothing worked then we started  10ml lactulose a day and he starrted going every day. We went down to 5 ml a day after a while he couldnt go anymore and we added cisapride 2 times a day now he is fine.
But he isnt eating much.
As you seem to be the only person using cisapride with lactulose I know, what do you suggest? Is it lactulose or cisapride that stops his appetite. Do you find they work best when given together?
Ill try the babyfood.
thx
228686 tn?1211554707
I'm just going to mention (in case I didn't earlier) that anytime we get digestive problems like this around here, we switch our cats over to a milk replacer diet and give them water via feeding syring for a few days to a week. I'm not saying it's the answer now, but I wonder if the high water content from the mix makes a big difference in preventing impaction.

I also spoke to someone on another board who says the feed their cat vaseline and it helps with this problem. I'VE never heard of this; has anyone else?
Avatar universal
I had a 13 year old Siamese who has been going through megacolon for a little over 5 years now. Five years ago, my other vet suggested the surgery and it was going to be $1,500, and they couldn't guarantee me his bowels would be normal. So I went to a different vet who recommended other options. I started using the lactulose and the cisapride, but he would throw up the lactulose. It was hard sometimes to try and give him the medicines knowing he hated it - he would go hide as soon as he heard me open the bottles. Anyway to make a long story short, my vet diagnosed him with the start of renal failure six months ago too. The vet told me when I started having to get the enemas more often I would know it was time as it wasn't a quality life for him. Monday, August 18 (day after my birthday) he was impacted again (after a month), so I made the decision to have him put to sleep. I just didn't want to put him through this anymore. Its been so hard.

Flash0817
Avatar universal
I'm so sorry, I haven't been on this page since June.  In case you still need an answer, I give Jax 1.5 ml of lactulose approx. 2 hrs before he get cisapride so that it can take effect and get moved out before it can cause unproductive straining.  

I hope the baby food worked for your kitty.  Please update me if you have a chance.
Avatar universal
My condolences.  I believe your kitty is doing much better after having crossed the rainbow bridge.
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